Case Reports in Ophthalmology (Dec 2017)

Bitot’s Spots following Bariatric Surgery: An Ocular Manifestation of a Systemic Disease

  • Amanda R. Crum,
  • Divya Srikumaran,
  • Fasika Woreta

DOI
https://doi.org/10.1159/000485235
Journal volume & issue
Vol. 8, no. 3
pp. 581 – 589

Abstract

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Background: To present a case of ocular complications from vitamin A deficiency following bariatric surgery. Case Report: A 41-year-old woman presented with symptoms of dryness and diminished night vision. Examination revealed corneal punctate staining, keratinization of the conjunctiva, and multiple mid-peripheral white lesions at the level of the retinal pigment epithelium. Given the patient’s history of bariatric surgery, anemia, and vitamin D deficiency, further investigation into micronutrient levels was performed and indicated a severe vitamin A deficiency. Oral vitamin A supplementation resulted in the complete resolution of her symptoms within two months. Conclusions: Nutritional deficiencies following bariatric surgery are common and can be disruptive to normal systemic health and visual function. Given that the number of patients pursuing bariatric surgery for weight loss management has increased over the past 50 years, eye care professionals should be aware of the ophthalmic manifestations associated with micronutrient deficiency.

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